Manual driver for implant drills and method of dental implantation

ABSTRACT

A manual driver for a dental implant drill or other dental implant tools and the method of use for preparing for dental implantation are provided. The manual driver includes a handle, an extension shank and a chuck having an axial channel configured to receive and interlock an implant drill, and a fastening screw transverse to the axial channel. The method of manual preparation for dental implantation using the manual driver has a high precision, and reduces the risk of bone cracking caused by vibration of motor-driven drilling. The manual drilling method provides better tactile sensation and drilling control to the dentist. Further, the method avoids drilling irrigation, allows collection of virgin bone tissue from the drills, and reintroduces the collected bone tissue in the receiving bore to promote bone regeneration after the implantation.

CROSS REFERENCE TO RELATED APPLICATION

This application is a divisional of patent application Ser. No.11/698,231, filed on Jan. 25, 2007, which claims the benefit under 35USC 119 (e) of the provisional patent application Ser. No. 60/762,730,filed on Jan. 27, 2006. All parent applications are hereby incorporatedby reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to a manual driver configured to receiveand drive an implant drill or other dental implant tools, and themethods of manual preparation for dental implantation using the manualdriver.

BACKGROUND OF THE INVENTION

Currently, in all dental implantation procedures drilling is performedusing motor-driven drilling. Motor-driven drilling has certainadvantages, such as fast and less labor demanding, however, it also hasvarious drawbacks. For example, in the process of preparing dentalimplantation, drilling is frequently made on a location which has verythin bones. Since motor-driven drilling causes vibrations, at the areawhere bone is very thin it tends to cause cracking of the bone andrenders implantation impossible. Furthermore, motor-driven drillingprovides one directional drilling, i.e., clockwise, which generates morepressure on the surrounding bone, hence, this also poses a higher riskof bone cracking, as well as causes more trauma to the patient.Consequently, in some areas or situations implantations have beenconsidered not permissible because of the risks associated with thedrilling.

Furthermore, because of the high speed and the vibration of motor-drivendrilling, it requires substantial skills and experiences in propercontrol of the angulation of drilling. Often, a correction of drillingangulation needs to be made when the bore generated is not precisely inthe required angulation, particularly in an area, such as at the frontof the mouth, where a high precision is required. Additionally, usingmotor-driven drilling, the dentists have a limited tactile sensationabout the surrounding bone structures in the process of drilling.Clinically, a commonly seen accident is the drill penetrating into thesinus, the floor of the nose, or bone cortex (outer layer of bone) inthe preparation process for implantation in the upper jaw of thepatient.

Moreover, motor-driven drilling generates heat, therefore, water coolingof the drill and the bore is required. This is typically done using anirrigation device adjacent to the drill. With irrigation, frequently thecooling water is accumulated in the patient's throat, the surgicalprocedure has to be stopped until the patient clears his throat. Thisinterrupts the process and can be dangerous during drilling. Moreover,the cooling water also causes a further disturbance of the wound.

On the other hand, it has been found in the recent years that the bonetissue collected from the threads of the implant drills immediatelyafter the drilling can be used to enhance bone regeneration around theimplant. Typically, the dentist collects the bone tissue from thethreads of the implant drills used in drilling, after the implant isplaced inside the bore, the collected bone tissue is placed around theimplant before suturing the wound. However, in the presence ofirrigation, the bone tissue collected is washed by the cooling water.Typically, a dentist harvests bone tissue using a bone trap connected toa suction hose, and sucks away the cooling water and collects bonetissue on a filter in the trap. Such a process can cause dehydration ofthe bone tissue, which affects the quality of the collected bone tissue,and bone regeneration surrounding the implant.

Therefore, it is desirable to provide improved tools and methods tosolve the problems described above, and achieve a better precision andcontrol of the dental implantation process. The present inventionaddresses this long felt need in the field.

SUMMARY OF THE INVENTION

In one aspect, the present invention is directed to a manual driver foran implant drill or other dental implant tools. The manual drivercomprises a chuck having an axial channel with an opening at a distalend of the chuck and a stop in a proximal portion of the chuck, and afastening screw transverse to the axial channel adjacent to the stop,the axial channel including an abutment portion for interlocking with ashaft of the implant drill; an extension shank integral with andextending from the proximal portion of the chuck along a longitudinalaxis of the manual driver; and a handle extending from a proximal end ofthe extension shank along the longitudinal axis. The proximal portion ofthe chuck includes a threaded transverse bore disposed at the abutmentportion of the axial channel for receiving the fastening screw.

In a further aspect, the present invention is directed to a manualpreparation method for dental implantation. In one embodiment, themethod comprises the steps of providing a manual driver comprising ahandle and a chuck configured to receive and lock an implant drilltherein; securing a shaft of a first implant drill into the chuck of themanual driver; manually driving the first implant drill at a selectedlocation to create an initial bore by turning the driver clockwise andcounter clockwise until the first implant drill reaching a desireddepth; taking a x-ray image of the initial bore to confirm properangulation of the initial bore; manually driving one or more implantdrills that has an increased diameter from the first implant drill usingthe manual driver to expand the initial bore by turning the driverclockwise and counter clockwise until obtaining a final bore having adesired diameter; removing the implant drills, and collecting bonetissue on threads of each of the implant drills into a sterilizedcontainer; placing collected bone tissue back into the final bore; andplacing the dental implant into the final bore that is filled with thecollected bone tissue. Preferably, after the first drilling, the firstimplant drill is remained in the initial bore for taking the x-rayimage, and to prevent bleeding.

In a further embodiment, the present invention is directed to a methodof immediate dental implantation. The method combines extraction of aselected tooth and implanting the dental implant in one surgicalprocedure. The preparation for implantation is substantially the same asthe process described above, except that the drilling starts with thecavity generated from extraction of the tooth.

The manual driver and the method of the present invention have variousadvantages over the existing motor driven drilling method, which willbecome apparent from the hereinafter set forth Detailed Description ofthe Invention and Claims appended herewith.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of the manual driver.

FIG. 2 is an enlarged perspective view of the chuck and the extensionshank of the instant manual driver.

FIG. 3 is an example of a commercial available implant drill that may beused with the manual driver of the present invention.

FIG. 4 is a side view of the manual driver, including an implant drillsecured therein.

FIG. 4A is a fragmentary axial cross-sectional view along thelongitudinal axis of said manual driver.

FIG. 4B is a bottom view of the chuck shown in FIG. 4.

FIG. 5 is a fragmentary axial cross-sectional view along thelongitudinal axis of said manual driver, showing a variation of thetransverse bore and an Allen head screw.

FIG. 6 is a fragmentary axial cross-sectional view along thelongitudinal axis of said manual driver, showing the enlarged screw headbeing disposed outside of the transverse bore.

It is noted that in the drawings like numerals refer to like components.

DETAILED DESCRIPTION OF THE INVENTION

In one aspect, the present invention provides a manual driver for dentalimplant drills or other dental implant tools.

With reference to FIGS. 1 thru 4B, in one embodiment, manual driver 10comprises a chuck 20, an extension shank 80 connected to a proximal end24 of chuck 20 and a handle 90 connected to a proximal end 84 ofextension shank 80, all coaxially aligned on longitudinal axis 2 ofmanual driver 10.

In the embodiment shown, chuck 20 has a conical distal portion 30 whichtapers toward distal end 22 of chuck 20, and a generally cylindricalproximal portion 40. Distal portion 30 has an axial channel 34 extendingthrough the entire distal portion, and further into proximal portion 40as described hereinafter. Axial channel 34 has an opening 36 at distalend 22 of chuck 20. It should be understood that the distal portion canalso have other suitable shapes, such as cylindrical and elliptical.

In the embodiment shown, proximal portion 40 has a U-shape like cut-out50. The proximal end 56 of cut-out 50 forms a stop, and distal end 54 ofcut-out 50 intersects with axial channel 34, therefore, the lowerportion of the axial channel 34 extending beyond distal end 54 ofcut-out 50 into proximal portion 40, as shown in FIGS. 2 and 4A. Thebottom of cut-out 50 forms a planar surface 52 in parallel withlongitudinal axis 2 of manual driver 10. In the structure shown, planarsurface 52 functions as an abutment portion 38 of axial channel 34 forinterlocking with the shaft of an implant drill, as more fully describedhereinafter.

A threaded transverse bore 58 is disposed transverse to the longitudinalaxis 2 and intersecting with planar surface 52. Disposed withintransverse bore 58 is a fastening screw 60, with a screw head 64adjacent to the periphery of chuck 20, in other words, away from planarsurface 52 of cut-out 50, as shown in FIG. 4A.

As can be seen in FIGS. 4 and 4A, cut-out 50 renders visible theproximal portion of the shaft of an implant drill when the shaft issecured to manual driver 10. This helps the dentist to ensure that theimplant drill, or other implant tools, is in position. However, itshould be understood that cut-out 50 is optional. In the absence ofcut-out 50, abutment portion 38 can be in a form of a step up planarplatform adjacent the inner end of axial channel 34. In this case, theinner end of axial channel 34 is the stop.

FIG. 3 shows a commonly used implant drill 100, which is commerciallyavailable from various manufacturers. Implant drill 100 has a threadeddrill head 120 and a shaft 130. Shaft 130 is cylindrical and the neckportion 136 of shaft 130 is stepped to provide a recess 132 therein.Typically, there is a transverse groove 134 in communication with recess132. When in use, neck portion 135 of implant drill 100 is inserted intoaxial channel 34 through opening 36 all the way to the proximal end 56of cut-out 50, recess 132 of shaft 130 is disposed on planar surface 52,i.e., abutment portion 38 of axial channel 34, therefore, abutmentportion 38 and recess 132 of shaft 130 are interlocked with each other.As such, rotation of manual driver 10 causes drill 100 to rotate. It isnoted that groove 134 is provided for further interlocking with somedrill holders, it is not required when the drill is used with theinstant manual driver.

In addition to the interlocking mechanism between abutment portion 38 ofaxial channel 34 and recess 132 of shaft 130, a fastening screw 60 isused to fasten shaft 130 of implant drill 100 in the position. As such,implant drill 100 is firmly secured in manual driver 10, and no slidingor wobbling within the driver occurs when it is used in a surgicalprocedure. The stability of the implant drill within the instant manualdriver is critically important, because the success of an implantreplies on the precision of the drilling. Any wobbling of the implantdrill, or implant tools, could cause errors in angulation and desiredstructure of the bore, and hence cause improper positioning of thedental implant or improper interface with the surrounding bone tissue.

FIG. 4A shows a cross-sectional structure of threaded transverse bore 58and fastening screw 60 in one embodiment. As shown, threaded transversebore 58 has a recess 59 at the outmost end thereof, adjacent to theperiphery of chuck 20, and screw 60 has a screw head 64 disposed withinrecess 59. When it is tightened, screw head 64 does not protrude fromchuck 20, therefore, the chuck has a smooth exterior surface. Fasteningscrew 60 can be tightened using a screw driver by engaging with ahexagonal opening 65 on screw head 64. Hexagonal opening 65 iscompatible with standard dental screw drivers, therefore, moreconvenient to the dentist. However, other structure, such as a slot canalso be used on the screw head. Typically, fastening screw 60 has arelatively small diameter, for example about 1.3 mm. Therefore, a screwhead with an enlarged diameter can be easier for the dentist to workwith, and is more durable because the implant drill is changedfrequently, from surgery to surgery and can be several times within onesurgery.

FIG. 5 illustrates an alternative embodiment, wherein an Allen headscrew 60′ is used. In this situation, threaded transverse bore 58′ ofchuck 20′ does not have the recess, however, the screw head is disposedwithin threaded transverse bore 58′. FIG. 6 illustrates a furtheralternative embodiment, wherein chuck 20′ includes a threaded transversebore 58′ and a fastening screw 60″ has a longer stem with a screw head64″ disposed outside the periphery of chuck 20′.

In addition to implant drill 100, various commercially available dentalimplant tools, such as rotational bone expanders, bone Trephine drills,tissue punches, have the same latch type neck structure on the shaft ofthe tools, as shown in implant drill 100 in FIG. 3. These tools can beused with the manual driver 10 of the present invention.

Preferably, chuck 20, extension shank 80 and handle 90 are integrallyconnected. Chuck 20 and extension shank 80 are preferably made ofstainless steel. However, other suitable materials can also be used forthe chuck and extension shank, such as titanium and high densityplastics. Preferably, handle 90 has an ergonomic shape, such as thestructure shown in FIG. 1, to support stable hand gripping. The exteriorof the handle can further include grooves to prevent sliding of thehand. Preferably, portion of the handle, such as the exterior portion,is made of a suitable plastic material which has a lighter weight thanmetal. Therefore, the manual driver is not too heavy for the dentist tooperate with freedom and comfort.

In a further aspect, the present invention provides methods of using themanual driver for dental implant procedures.

In one embodiment, the method is directed to a manual preparationprocess for dental implantation. The method is described hereinaccording to the sequence of the process steps using manual driver 10.First, a manual driver 10 is provided, and a first implant drill issecured into chuck 20 by inserting the shaft of the first implant drillall the way to stop 54 and tightening fastening screw 60. Then, thefirst implant drill is manually driven into a selected location in apatient's mouth to create an initial bore by turning manual driver 10back and forth, i.e., clockwise and counter clockwise, until the firstimplant drill reaching a desired depth. Herein, the bore created bydrilling is also referred to as osteotomy site. At this stage, manualdriver 10 is removed from the shaft of the first implant drill byloosening the fastening screw 60, while the first implant drill is leftwithin the initial bore. Then, a x-ray image of the initial bore istaken to confirm proper angulation of the initial bore. Upon confirmingthe proper angulation, the first implant drill is removed from theinitial bore by turning back and forth, and then the bone tissue onthreads of the first implant drill is collected in a sterilizedcontainer. At this stage, if angulation of the initial bore is improper,further drilling with the first implant drill to correct the angle ofthe initial bore is performed. After the initial drilling, the initialbore is expanded using one or more implant drills that have asequentially, or stepwise, increased diameter from the prior implantdrill. In each drilling, the implant drill is secured into manual driver10 as described above, and the drilling is performed manually by turningthe driver clockwise and counter clockwise. In this step, typically oneto three implant drills can be used until obtaining a final bore thathas the desired diameter. After each step of drilling, the implant drillis retrieved from the bore, and the bone tissue on threads of theimplant drills is collected into the sterilized container. Once thefinal bore is obtained, the collected bone tissue is placed back intothe final bore, using a specula or other suitable tools. After filling,a plugger can be inserted to push the bone tissue down. Typically, about30% to about 50% of the interior of the final bore is filled with thecollected bone tissue. Then, a predetermined dental implant is placed,using the conventional method, into the final bore that is filled withthe collected bone tissue. When the implant is in place, the area aroundthe top of the dental implant is further packed with the collected bonetissue. Then, an absorbable collagen wound dressing is applied, and thegum is sutured according to the requirement of the subsequent implantprocedures.

Furthermore, after the initial drilling one or more rotational boneexpanders can be used in addition to a minimal amount of drilling toexpand the diameter of the bore. Using rotational bone expanders caneffectively expand the diameter of the bore with minimal loss of bonetissue and effectively increase bone density around the bore, which hasbeen found to produce more stable anchoring of the implant, and enhancebone regeneration at the interface between the implant and thesurrounding environment.

Moreover, the collected bone tissue can also be mixed with humanallograft tissue, for example, Grapton® demineralized bone matrixavailable commercially from Osteotech Inc. (Eatontown, N.J.), prior toplacing into the final bore. Preferably, the mixture can have a ratiofrom about 1:2 to about 2:1 between the two components. In severaldental implant procedures performed using the instant manual driver andthe method, a 1:1 mixture of the collected bone tissue and Grapton®demineralized bone matrix is used. Using the mixture helps to achievethe desired bone volume. Furthermore, it has been found that the mixturelasts longer in the osteotomy site, which is more effective forfacilitating local bone regeneration.

The method of the present invention has various advantages in comparisonto the traditional process of preparing the bore using motor-drivendrilling, which are described in detail below.

First, motor-driven drilling has a very high speed, typically from about400 to about 2,000 rpm, which causes vibrations in the surrounding bone.At the area where bone is very thin, motor-driven drilling tends tocause cracking of the bone and renders implantation difficult orimpossible. Furthermore, motor-driven drilling provides one directionaldrilling, i.e., clockwise, which generates pressure on the surroundingbone, causes more trauma to the patient and poses risks of bonecracking. Using manual drilling, as provided above with the instantmanual driver and the method, the drilling does not cause vibration.Moreover, turning the drill clockwise and counter clockwise, manualdrilling generates less pressure in the surrounding bone. Consequently,it has a substantially lower risk for cracking the bone. It has beenfound that in several situations where the implantations were notpermissible with the traditional motor-driven drilling because of therisks associated with the drilling, the implantations were successfullyperformed using the manual driver and the method of the presentinvention.

Second, using the instant manual driver the precision of the drillingcan be better controlled. With motor-driven drilling, prior to enteringinto the bone, the drill head tends to wobble on the exterior surface ofthe bone, which renders the control of the location and angulationdifficult. Furthermore, during drilling the vibration also causesdifficulty in controlling angulation. On the other hand, manual drillingis substantially slower, it does not cause vibration, and the speed canbe well controlled by the dentist. As such, it is easier to achieve aproper angulation of the bore, which ultimately results in a moresuccessful implantation.

Furthermore, it has been found that using the instant manual driver, thedentist has a better tactile sensation during the drilling process. Whenthe dentist senses a density change or more difficult to proceed withdrilling, this indicates a local structural change, such as in thesituation when the drill is approaching the sinus, or the floor of thenose. Under such circumstances, the dentist can stop drilling to examthe situation and timely adjust the process. Because of the high speedand vibration associated with the motor-driven drilling it is difficultfor the dentist to sense the structural change, and hence, difficult torespond timely without substantial experiences. Clinically, it happensoften that motor-driven drilling causes penetration into the sinus, thefloor of the nose, or bone cortex in the process of preparingimplantation in the upper jar. Using the manual driver and method of thepresent invention, the risk of accidents due to lack of sensation andcontrol from the dentist is reduced substantially. Even with a lessexperienced professional, those difficult situations can be bettercontrolled with manual drilling.

Third, motor-driven drilling generates heat because of its high speed,therefore, water cooling of the drill and the bore is required. This istypically done using an irrigation device adjacent to the drill. In thepresence of irrigation, it is more difficult to collect bone tissue, andthe bone tissue collected is washed by the cooling water. Irrigationfurther causes additional disturbance of the wound. Moreover, irrigationcan interfere the dentist's operation because of the water spiting fromthe drill. Sometimes, the cooling water is accumulated in the patient'sthroat, the drilling has to be stopped to allow the patient to clear histhroat. With a motor-driven drilling procedure, a dentist typicallyharvests bone tissue using a bone trap connected to a suction hose, andsucks away the cooling water and collects bone tissue on a filter in thetrap. This method can cause dehydration of the bone tissue, whichaffects the quality of bone tissue, and bone regeneration around theimplant.

Substantially different from the motor-driven drilling process, themanual drilling method of the present invention does not generate heat,therefore, no cooling water is used. Consequently, it is easier toharvest the bone tissue from the implant drills, and the bone tissuecollected is virgin bone tissue, meaning not washed, or contaminated bynon-natural materials, such as the cooling water, and not dehydrated.Because the collected bone tissue is substantially natural, afterplacing it back into the bore, it is more effective in promoting localbone regeneration after the implantation. Furthermore, without heatingthe very costly implant drills can also be used longer.

Additionally, the instant method fills the bone tissue into the boreprior to placing the implant. This ensures the bone tissue filling inall available spaces between the implant and the bore, and hence is moreeffective in enhancing local bone regeneration after the implantation.

Fourth, traditionally, after the initial drilling the first implantdrill is removed from the initial bore, then a pin is inserted into thebore as an indicator for the x-ray image. In the instant method, thefirst implant drill is remained within the initial bore after theinitial drilling without removal, it has been found that it reducesbleeding within the bore, therefore, no cleaning of blood, either byrinsing or using gauze, is required. This reduces the process steps, andreduces the agitation of the surrounding tissue. The instant manualdriver can be easily separated from the implant drill by loosening thefastening screw and sliding the chuck away from the shaft of the implantdrill.

Based on the above description, it can be appreciated that the instantmethod provides better precision and control in preparation for dentalimplantation, poses less stress and trauma to the surrounding tissue,and reduces risks associated with drilling. Furthermore, it allowscollection of virgin bone tissue for bone grafting at the implant site.

In a further embodiment, the method is directed to an immediate dentalimplantation process. Herein, the term of “immediate dental implantationprocess” refers to a surgical procedure wherein the implant is placedimmediately after the extraction of a tooth. In contrast, the morecommonly used implant process involves two separate surgical procedures,one for extraction and one for implantation, which is typically arrangedtwo to three months later after the cavity formed from the extraction isno longer present because of bone regeneration.

In this embodiment, the method steps are the same as those describedabove except the followings. A selected tooth is extracted using theconventionally method, which results in a cavity that typically has anoval shape, not cylindrical. The wall of the cavity is cleaned andrinsed. At the initial drilling, the first implant drill is manuallydrilled beyond the bottom of the cavity, in other words, the initialbore is deeper. Then, all previously described method steps are used inthis process. The final bore generated may not be perfectly cylindrical,therefore, certain portions of the wall of the final bore may not be indirect contact with the dental implant. However, because the collectedbone tissue from the drilling is filled into the final bore, when thedental implant is placed in, the collected bone tissue fills in thespace between the implant and the wall of the final bore. Therefore, thesurface of the dental implant is completely surrounded by bone tissue,either by the wall of the final bore, or by the collected bone tissuefrom the drilling.

It has been found that using the manual driver and method of the presentinvention, the implantation process is simplified and easier to control,and hence the surgery is faster. More importantly, the risks associatedwith the surgery are substantially reduced, and the patients recoverfaster.

While there has been shown and described the preferred embodiment of theinstant invention it is to be appreciated-that the invention may beembodied otherwise than is herein specifically shown and described andthat, within said embodiment, certain changes may be made in the formwithout departing from the underlying ideas or principles of thisinvention as set forth in the Claims appended herewith.

1. A manual driver for an implant drill or a dental implant toolcomprising: (a) a chuck having an axial channel with an opening at adistal end of said chuck and a stop in a proximal portion of said chuck,and a fastening screw transverse to said axial channel adjacent to saidstop, said axial channel including an abutment portion for interlockingwith a shaft of said implant drill; (b) an extension shank integral withand extending from said proximal portion of said chuck along alongitudinal axis of said manual driver; and (c) a handle extending froma proximal end of said extension shank along said longitudinal axis. 2.The manual driver of claim 1, wherein said proximal portion of saidchuck is generally cylindrical and a distal portion of said chuck isconical tapering toward said distal end.
 3. The manual driver of claim2, wherein said proximal portion of said chuck includes a cut-out havinga planar surface in parallel with said longitudinal axis of said driver,said cut-out rendering visible a proximal portion of said shaft of saidimplant drill when said shaft is secured to said dental driver.
 4. Themanual driver of claim 1, wherein said proximal portion of said chuckincludes a threaded transverse bore disposed at said abutment portion ofsaid axial channel for receiving said fastening screw.
 5. The manualdriver of claim 4, wherein said threaded transverse bore has a recess atan outmost end thereof, adjacent to a periphery of said proximal portionof said chuck, and said fastening screw has an enlarged screw headdisposed within said recess of said threaded transverse bore.
 6. Themanual driver of claim 4, wherein said fastening screw is an Allen headscrew.
 7. The manual driver of claim 4, wherein said fastening screw hasan enlarged screw head disposed outside of said threaded transversebore.
 8. The manual driver of claim 1, wherein said handle is taperedtoward said extension shank, providing an ergonomic shape for engagementwith hands.